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Heparin protocols are standardized procedures personnel at a hospital or clinic follow when they administer heparin to reduce the chance of errors. Heparin is a potent anticoagulant medication, and a patient could become very ill if care providers make a mistake. Protocols create a simple, clear guideline for how to handle this medication and eliminate guesswork. There may be a facility-wide procedure everyone must follow, and some doctors also have their own protocols.
When heparin is indicated because a patient has a clotting problem and she needs treatment to limit the formation of new clots, the heparin protocols must be followed. These start with obtaining an accurate weight and using a standardized dosing chart. Doctors usually must write out their orders in full, including the initial loading dose to get the clotting under control as well as the recommended bolus dose. Some facilities encourage doctors to round off their doses so a patient receives, for example, 12 units, rather than 12.358 or some other fractionated number that could create a margin of error.
In addition to providing standard procedures when writing up orders for heparin, the heparin protocols also offer guidance on how to monitor patients. This includes regular blood testing to see how the patient responds to treatment. The partial thromboplastin time (PTT) test is a measure of blood clotting the hospital can use to check on the patient's response to heparin. The goal is to give the patient enough anticoagulant to resolve the clotting problem, without giving so much that the patient loops back in the other direction and has dangerously low clotting factors that could cause a dangerous bleed.
The use of heparin protocols reduces mistakes in a clinical setting. Even experienced care providers can make errors, and standards create a mechanism for all members of the care team to speak up if they identify a problem. If a doctor estimates the dose, for example, a nurse can say that she didn't see the doctor checking the patient's weight as the heparin protocols mandate. The doctor will need to respond, and this can provide an opportunity to correct a dosing error that might otherwise have gone unnoticed.
Most facilities write up their protocols for heparin and other drugs, as well as various medical situations, in an employee manual. All new hires must read through the manual and usually sign documentation to indicate that they read and understood the information. Copies are maintained at locations like nursing stations for quick reference, as the protocols often include dosing charts and other useful materials.
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